Action Points

Explain that patients in this study saved about 30% by stocking up on their chronic medications in three-month supplies, rather than buying just one month at a time, and their insurers saved about 18%.

Buying prescription drugs in bulk reduces costs for both patients and their insurers, researchers say.

Patients saved about 30% by stocking up on their chronic medications in three-month supplies, rather than buying a month's supply, G. Caleb Alexander, MD, of the University of Chicago Medical Center, and colleagues reported in the Nov. 20 issue of Applied Health Economics & Health Policy.

"Millions of patients are burdened by their prescription costs, and promoting the use of three-month supplies of medicines for chronic conditions is one way that patients, physicians, and policymakers can help reduce this burden without compromising quality of care," Alexander said.

The researchers looked at data from the Medical Expenditure Panel Survey 2000-2005 involving 2,971 patients who filled prescriptions for at least one one-month supply and at least one three-month supply of their medications. The drugs treated chronic conditions that included high cholesterol, hypertension, hypothyroidism, and depression.

A total of 44% of prescriptions were dispensed as three-month supplies.

On average, patients' out-of-pocket costs were $20.44 for a one-month supply, but that dropped to $15.10 per month for a three-month stock, the researchers found. In multivariate analyses, that translated to a 29% savings.

The vast majority -- 80% of patients -- achieved some savings by buying in bulk.

If each of all the one-month prescription had instead been dispensed as three-month supplies, the researchers said, patients would have saved about $148.6 million in out-of-pocket costs, and insurers would have saved $196.5 million.

Even so, Alexander noted that prescription drug costs represent only about 10% of the nation's overall healthcare costs.

"Clearly even if we can reduce the cost of prescription medicines through greater efficiency, there are still important changes needed in other healthcare sectors, such as hospitalizations and emergency department use," he said.

Nevertheless, he said, the savings calculated in their report are "substantial," and play a role in the "phenomenon of cost-related nonadherence"

Alexander said 20% to 30% of patients who take medications for chronic conditions reported skipping or stretching their drugs in the past year because of cost.

"So if we can reduce costs of prescription medications, we can increase adherence, and that will likely have an important impact on downstream healthcare costs such as unnecessary use of EDs and unnecessary hospitalizations," he said.

Alexander also emphasized the impact that buying in bulk will have on seniors and low-income patients.

"A five-dollar savings per prescription may not seem like a big deal to a lot of people, but for seniors, many of whom are living on fixed incomes, this savings is substantial," he said. "You have to keep in mind that many seniors take two or three or sometimes even five or seven prescription medications a day. So if you consider the amount of prescriptions people take as well as limited incomes, this savings is substantial."

The researchers noted that the out-of-pocket effects were more modest when applied to generics rather than brand-name drugs, but estimates of the savings persisted.

They also said the study was limited in that it did not have dosing data and could not account for potential waste and inefficiency that may be associated with filling but not using all of a three-month supply.

Alexander has received awards from the Agency for Healthcare Research and Quality and the Robert Wood Johnson Physician Faculty Scholars Program.

He has served as a consultant for IMS Health and has previously received grant funding from Merck and Pfizer and has served as a consultant to AstraZeneca.

Kristina Fiore joined MedPage Today after earning a degree in science, health, and environmental reporting from NYU. She's had bylines in newspapers and trade and consumer magazines including Newsday, ABC News, New Jersey Monthly, and Earth Magazine. At MedPage Today, she reports with a focus on diabetes, nutrition, and addiction medicine.

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